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JOURNAL REVIEW
Year : 2019  |  Volume : 57  |  Issue : 2  |  Page : 186-187

Journal scan


1 Department of Cornea, RIO GOH, M. N. Eye Hospital, Chennai, Tamil Nadu, India
2 Department of Paediatric Ophthalmology and Strabismus, M. N. Eye Hospital, Chennai, Tamil Nadu, India

Date of Web Publication10-Sep-2019

Correspondence Address:
Dr. Nivetha Gandhi
Department of Cornea, RIO GOH, Chennai, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/tjosr.tjosr_59_19

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How to cite this article:
Gandhi N, Vadivelu SD, Nishanth S. Journal scan. TNOA J Ophthalmic Sci Res 2019;57:186-7

How to cite this URL:
Gandhi N, Vadivelu SD, Nishanth S. Journal scan. TNOA J Ophthalmic Sci Res [serial online] 2019 [cited 2019 Sep 22];57:186-7. Available from: http://www.tnoajosr.com/text.asp?2019/57/2/186/266399




  Improving Vision in Adult Amblyopia by Perceptual Learning Top


Polat U, Ma-Naim T, Belkin M, Sagi D. Improving vision in adult amblyopia by perceptual learning. Proc Natl Acad Sci U S A 2004;101:6692-7.

Aim: To study the outcome of perceptual learning training in improving vision in adult amblyopia. Practicing certain visual tasks leads, as a result of a process termed “perceptual learning,” to a significant improvement in performance. Methods: This is a prospective, randomized, masked, controlled study. Included were patients, aged between 9 and 55 years, with unilateral amblyopia secondary to strabismus and/or anisometropia. A total of 77 amblyopic patients (divided into two treatment amblyopic groups [63 patients] and two control amblyopic groups [14 patients]) and 16 subjects with normal vision (control group) participated in the study. Each study participant had 2–4 weekly treatment sessions of ≈ 30 min each, totaling 45 ± 15 sessions. A standard training session included a Gabor signal contrast-detection task with and without flanking collinear high-contrast patches. Results: The control subject shown was trained with high-contrast targets without flankers and showed no improvement. The combined treatment group showed a rapid 35% improvement (during the first eight sessions), followed by a slower learning rate, reaching 78% gain after 48 training sessions. An improvement of two or more ETDRS lines was achieved by 43 patients (68%), and 40 of the 48 patients (83%) who started with a visual acuity (VA) worse than 6/12 ended their treatment with a VA better than 6/12.

Take-home message

The results show that the use of a structured training method like perceptual learning, targeted at the specific deficiencies in amblyopia, helps to improve vision in amblyopic adults.


  Comparative Analysis of the Safety and Efficacy of Intracameral Cefuroxime, Moxifloxacin, and Vancomycin at the End of Cataract Surgery: a Meta-Analysis Top


Bowen RC, Zhou AX, Bondalapati S, Lawyer TW, Snow KB, Evans PR, et al. Comparative analysis of the safety and efficacy of intracameral cefuroxime, moxifloxacin and vancomycin at the end of cataract surgery: A meta-analysis. Br J Ophthalmol 2018;102:1268-76.

Background: Current practice methods are unclear so as to the safest and effective prophylactic pharmacotherapy and method of delivery to reduce postoperative endophthalmitis occurrence. Methods: A systematic review and meta-analysis using Meta-analysis of Observational Studies in Epidemiology guidelines was performed to compare the efficacy of intracameral cefuroxime, moxifloxacin, and vancomycin in preventing postphacoemulsification cataract surgery endophthalmitis. A safety analysis of intracameral antibiotics was concurrently performed. Results: Seventeen studies with over 900,000 eyes were included, which favored the use of intracameral antibiotics at the end of cataract surgery. The average weighted postoperative endophthalmitis incidence rates with intracameral cefuroxime, moxifloxacin, and vancomycin were 0.0332%, 0.0153%, and 0.0106%, respectively. Secondary analyses showed no difference in efficacy between intracameral plus topical antibiotics and intracameral alone (P > 0.3). Most studies had low-to-moderate risk of bias. The safety analysis showed minimal toxicity for moxifloxacin. Dosing errors led to the majority of toxicities with cefuroxime. Although rare, vancomycin was associated with toxic retinal events.

Take-home message

Intracameral cefuroxime and moxifloxacin reduced endophthalmitis rates compared with controls with minimal or no toxicity events at standard doses. In addition, intracameral antibiotics alone may be as effective as intracameral plus topical antibiotics.


  Extraocular Needle-Guided Haptic Insertion Technique of Scleral Fixation Intraocular Lens Surgeries (X-Nit) Top


Baskaran P, Ganne P, Bhandari S, Ramakrishnan S, Venkatesh R, Gireesh P, et al. Extraocular needle-guided haptic insertion technique of scleral fixation intraocular lens surgeries (X-NIT). Indian J Ophthalmol 2017;65:747-50.

Background: The study describes “extraocular needle-guided haptic insertion technique” (X-NIT), a novel technique of exteriorizing haptics in sutureless sclera fixation of intraocular lens that totally eliminates intraocular manipulations. The conventional handshake technique has a learning curve since it involves intraocular handing over of haptics from one forceps to another. Technique: Two linear, partial-thickness scleral tunnels of 3-mm length are made 1.5 mm behind limbus. A self-sealing sclerocorneal wound of 5.5 mm is made. Two standard 26-gauge needles are bent to 60° near the hub. The first bent 26-gauge needle is pierced through a silicone stopper. This needle is then introduced into the scleral tunnel at the 3 o' clock meridian and is redirected and brought out through the pupil and the sclerocorneal wound. The leading haptic of a three-piece polymethyl methacrylate IOL is threaded into the needle using McPherson forceps. The 26-gauge needle is then withdrawn out of the sclerotomy along with the leading haptic. The silicone stopper is now slid over the needle shaft and helps prevent slippage of the exteriorized haptic. The second bent 26-gauge needle is inserted through the sclera at the 9 o' clock meridian, and the trailing haptic is exteriorized. The silicone stopper on the leading haptic is removed and both haptics are tucked into the scleral tunnels, and the IOL is centered. Results: Nineteen consecutive patients underwent surgery by this technique. There were no intraoperative complications. The mean best-corrected visual acuity (BCVA) of these patients at 1-month follow-up was 0.5 ± 0.3 (logarithm of the minimum angle of resolution) with 18 of 19 eyes showing one or more lines of improvement in BCVA.

Take-home message

X-NIT is a safe, easy, cost-effective, and highly reproducible technique, especially for beginners.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.






 

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